Evidence Update: Impact of Walking on Breast Cancer Recurrence
Exercise has the potential to reduce the risk of breast cancer recurrence and improved survival by about 40%. Physical activity recommendations include achieving 150 minutes of moderate or 75 minutes of vigorous aerobic exercise per week, stretching, and strengthening major muscle groups at least 2 times per week. However, studies show that less than 13% of patients with breast cancer achieve this recommendation. Join us this month to learn a customized walking plan to add to your exercise program. Let us know what exercise program you might like to see at TP. Hamer et al, 2017. Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health. CMAJ. 2017 Feb 21; 189(7): E268–E274.
Patient Perspective: George
“You have Breast Cancer”! Those words strike fear in the hearts of women who hear it – and the men too! While less than 1% of men get breast cancer, the diagnosis is no less devastating! In my case, it was even more shocking for me because the breast cancer diagnosis came 10 months after I had a robotic prostatectomy to address prostate cancer. Even though my mammogram (I can appreciate what you go through, ladies) only showed a mass on my right side, because both my nipples had inverted, and at the urging of my surgeon, I decided to have a double mastectomy. As it turns out, there was cancer in the left breast also. I feel so fortunate because so many men who find out they have breast cancer are in the later stages because they have no symptoms. When I was first diagnosed, I spent a lot of time learning about breast cancer, particularly in men. I found myself, in one breath, cursing my body for this disease, and in the next breath, thanking it for inverting my nipples. That is how I knew something was wrong. The message here is “Listen to your body!” I told my wife, “I beat prostate cancer, and I will beat breast cancer”. Even though I was confident in saying that, a cancer diagnosis has a way of making you look at life differently, including starting to think about getting your affairs in order and realizing that some things you thought were important are really not so important. The other thing I realized after both of my diagnoses, is that your life becomes a series of important decisions. What kind of treatment will you have? Who is the doctor or team of doctors to treat you? When will you start treatment? What happens after treatment? I found it so helpful to have a strong support system headed by my wife. She has been so important in both my recoveries. After my double mastectomy, my surgeon recommended TurningPoint and I am so glad he did. The staff is warm, welcoming and accommodating. Both of my therapists were great! They were knowledgeable, kind and caring, (but they still made me do the work)! My range of motion is very good and I continue to do my exercises at home (I can still hear my therapists’ voice checking on my progress)! I highly recommend TurningPoint for anyone after breast cancer surgery!
Patient Perspective: Amy
I am a stay at home mom, and when not on homework/bus stop duty, I enjoy walking with friends for exercise and company, creating photo books of family adventures, and hanging out with my husband to catch up on our similar tastes in tv and movies. I also like reading all the survivorship stories and learning of upcoming events at TurningPoint. My story started like this: After waiting a few months to get an appointment, I saw a doctor in December of 2015 to have my right breast looked at as there was some unusual swelling. After an ultrasound, I was told to find a breast surgeon who then gave me recommendations for an oncologist. After a painful biopsy, I learned I would most likely have to go through chemo, a mastectomy, and radiation (in that order). I stayed positive even though it would be a tough year of treatments. My children, now 7 and 10 years old, were a little worried but enjoyed having extra playdates and lots of yummy food that friends and neighbors brought us. My wonderful husband supported me and never showed worry or stress on his part, and even was my nurse and took care of me by having permission to work from home. After the mastectomy in the summer, the radiation doctor told me I’d need to be able to move my arms up for the radiation beams and suggested a referral for physical therapy. A few people suggested TurningPoint and I was glad to find them! My therapists taught me lots of stretches to regain movement and I improved dramatically and was able to get back to my normal range of motion. The following summer I had tissue expanders filled and returned to TurningPoint for massage therapy to help with stiffness. Everyone at TurningPoint is caring, positive, and rooting for you to improve.
Evidence Update: Dental Health During & After Cancer Treatment
Once given the life-altering diagnosis of breast cancer, the furthest thing from the patient’s mind may be dental care. Planning for the oral health needs of the patient before chemotherapy or radiation therapy begins will improve outcomes and lower the risk of side-effects. Professional oral health care is a vital component to healthy oral habits long before a cancer diagnosis, but is essential before, during and after cancer treatment. Common side effects of chemotherapy and radiation may include mouth sores, dry mouth, pain, infection, difficulty chewing or swallowing, inflammation, and bone disease. Your dentist is an important part of your cancer care team and can help reduce and manage side-effects that may occur in the mouth during and after chemotherapy and radiation. Chemotherapy affects rapidly dividing cells like cancer cells but may also impact normal cells that divide rapidly like those in the oral cavity and gastrointestinal tract. Chemotherapy may also lower your white and red blood cell count as well as your platelet count. This is known as “bone marrow suppression” (myelosuppression), which may lead to increased risk of infection and / or bleeding. In fact, some pre-existing conditions such as cavities, abscesses or gum (periodontal) disease may become worse during treatment. If these conditions exist, it is important to address them prior to beginning cancer treatment. Mucositis – mouth sores – are often cited as the most common side-effect of chemotherapy. Other side-effects of chemotherapy may also include mouth pain, peeling of the tongue and even changes in taste. At times, mucositis may be severe enough to alter treatment regimens and even require prescription pain medication to alleviate the symptoms. One way to lessen the discomfort and even reduce the likelihood of mouth sores resulting from chemotherapy is to ask for ice chips or sugar free popsicles to suck on during treatment. Some mouth rinses that contain salt or baking soda may also help ease mouth sores. Unfortunately, there are not too many approved treatments for mucositis. Low-level lasers can relieve or cure the ulcers (sores), but much more definitive research is needed. Talking with a dietitian may help with changes in taste and identification of foods that cause less irritation to mouth sores and are easier to eat. Radiation is also used to destroy cancer cells, but as with chemotherapy can result in damage to healthy cells. Radiation to the head and neck area can damage salivary glands resulting in xerostomia (dry mouth). With xerostomia, salivary glands produce less saliva and the saliva that is produced is thicker. The importance of saliva cannot be overstated. It controls bacteria in the mouth by constantly rinsing the mouth, and it delivers part of the immune system into the oral cavity. Dry mouth can lead to difficulty speaking or swallowing as well as increased bacteria in the mouth, which can lead to cavities and gum disease. To reduce the impact of dry mouth, patients can soften or thin food with liquids, chew sugarless gum, and suck on ice chips. Your dentist may also prescribe a saliva stimulant to help ease dry mouth. Possibly the most significant complication of radiation therapy is osteonecrosis of the jaw – ONJ (weakening and loss of bone in the jaw). ONJ may result in pain, swelling, infection, loose teeth and even exposure of underlying bone tissue. The good news is that ONJ can be managed with oral antibiotics from https://www.pittsburgheyeassociates.com/amoxil-treat-infections/, proper dental hygiene and routine care by a dental professional. New studies are now being done with hyperbaric oxygen to understand how this treatment may aid in wound healing and the prevention of ONJ. Oral health side-effects resulting from chemotherapy and radiation treatments are a risk for patients and can even result in changes to the treatment regimen. New research is underway to better understand the underlying causes of mucositis, xerostomia, and osteonecrosis and identify ways to reduce these side-effects and improve treatment outcomes. Patients can improve and manage their oral health by including their dentist as part of their cancer care team and maintaining good oral health habits. Source: American Dental Association, American Society of Clinical Oncology & National Institute of Dental and Craniofacial Research.
